[eng] Contemporary medicine has at its disposal extraordinary technical efficiency. Paradoxically however, the criticisms levelled at it often give it the image ositting in the dock: the objectivity, the rationality of medical science do not seem to mix well with the patient’s word. In medical consultation, and more precisely in the contract which binds the user to the dispenser of care, are there only rights for the former and obligations for the latter? The right to have the children one wishes and the obligation to propose the latest technical equipment? Does a “living will” have a binding force on those dispensing care? Does medicine have to meet all requests and take care of happiness? This article examines what is at stake in these questions. This is perhaps linked to a question of meaning, that is to say the interaction between the meaning of medical practice, the direction it can, wishes to or has to take, and the way it is perceived in mental representations.